Individual provider Active NPI

Brian Bougard

  • Certified Registered Nurse Anesthetist
  • Memphis, TN
National Provider Identifier
1821613282
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28059 Issued in TN
Practice address
1068 Cresthaven Rd Ste 150
Memphis, TN 38119-3859
Phone
(901) 682-6828
NPI assigned
Jun 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 28059 TN Primary

Addresses

Primary practice location

1068 Cresthaven Rd Ste 150
Memphis, TN 38119-3859

Mailing address

1068 Cresthaven Rd Ste 150
Memphis, TN 38119-3859
Phone (901) 682-6828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200925001213 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305265281 Reassigns benefits to 5 organizations
I20260519000778 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305265281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Anesthesiology of Tennessee PCGroup PAC ID 9931001922, 296 clinicians

Practice addresses (Care Compare)

1500 W Poplar Ave
Collierville, TN 38017-0601
Phone (901) 861-9000

6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-5000

9300 Park W Blvd
Knoxville, TN 37923-4301
Phone (865) 546-8040

Hospital & facility affiliations

  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Tennessee, P.C. CurrentSince Jun 1, 2023 Accepting new patients
Medical Anesthesia Group, PA CurrentSince Nov 15, 2020 Accepting new patients
East Memphis Anesthesia Services PLC CurrentSince Sep 1, 2020 Accepting new patients
Lifelinc Anesthesia II, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 15, 2025 Accepting new patients
Lifelinc Anesthesia VIII PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2025 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2023 Accepting new patients

Locations

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

2986 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 765-1000

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

1265 Union Ave
Ste 201
Memphis, TN 38104
Phone (901) 516-7000

1300 Wesley Dr
Memphis, TN 38116
Phone (901) 516-3700

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

255 S Pauline St
Memphis, TN 38104
Phone (901) 261-2804

5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000

1068 Cresthaven Rd
Ste 150
Memphis, TN 38119
Phone (205) 789-5982

435 2nd St
Newport, TN 37821
Phone (423) 625-2200

100 Northcrest Dr
Springfield, TN 37172
Phone (615) 384-1531

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1821613282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 CRESTHAVEN RD STE 150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193859",
            "telephone_number": "901-682-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 CRESTHAVEN RD STE 150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193859",
            "telephone_number": "901-682-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUGARD",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-11",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "28059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.